Stolnicu S, et al. - Researchers investigated the applicability of the Silva invasion pattern-based classification system for all endocervical adenocarcinomas (ECAs), specifically focusing on those not associated with HPV. They corroborated that there was no association between pattern A and B HPV-associated endocervical adenocarcinomas (HPVA) lacking lymphovascular invasion (LVI) and lymph node metastases (LNM). They found non-HPV-associated (NHPVA) endocervical adenocarcinomas vs HPVA were larger and more invasive. In addition, clinical stage, not age or tumor size or morphology, determined the risk of lymph node metastasis for NHPVA ECAs. The irrelevance of Silva classification system to NHPVA ECAs was shown as these tumors belong to the most invasive Silva pattern. Overall, only in HPVA cervical adenocarcinoma, was it found relevant to apply the Silva system.